Tus neeg slimming, nws muaj zog nws txoj kev ntseeg siab tias yam li "kev rog" yuav tsis kov nws. Qhov tsis kaj siab qhov tshwm sim uas rog dhau tsis hem yog tias qhov hnyav yog qhov qub thiab daim duab zoo nkauj. Yog vim li cas, ntawm qhov kev kuaj niaj hnub, kev kuaj mob suab: "Fatty hepatosis"? Nws yog tag nrho hais txog visceral (abdominal) rog, enveloping peb cov kabmob sab hauv. Ib qho ntawm cov laj thawj tseem ceeb rau tus mob no yog ib qho genetic predisposition.
Fatty hepatosis (ZHBP, "fatty" daim siab, steatosis) yog cov txheej txheem pathological hauv daim siab, ua rau cov roj tee hauv hepatocytes thiab ua rau kom tiav degeneration ntawm nws cov ntaub so ntswg parenchymal rau hauv cov ntaub so ntswg adipose. Cirrhosis yog tshwm sim los ntawm lub siab rog. Yuav kho tus kab mob no li cas, nws cov tsos mob thiab kev kuaj mob li cas? Tsab xov xwm muab cov ncauj lus kom ntxaws uas yuav pab koj nrhiav cov lus teb rau tag nrho koj cov lus nug ntawm lub ncauj lus no.
Ua rau lub siab rog
Kab mob no muab faib uaob hom nyob ntawm qhov ua rau nws tshwm sim: ALD (alcoholic) thiab NAFLD (non-alcoholic). Nws tuaj yeem yog thawj lossis theem nrab. Cov lus hauv qab no qhia txog cov laj thawj tseem ceeb ntawm ib hom kab mob siab.
| Classifier | Type | Qhov laj thawj tseem ceeb ntawm FLD |
| vim yog vim li cas thiaj ua rau muaj tus kabmob | ABP | - haus ntau dhau mus ntev (muaj cov kab mob tshwm sim hauv lub sijhawm luv luv) |
| NAGB |
- kev noj zaub mov tsis zoo (qhov tseem ceeb ntawm cov rog tsis zoo); - tshuaj siv tshuaj (tshuaj tua kab mob, tshuaj hormones); - hormonal disorders (piv txwv li, thaum cev xeeb tub); - insulin tsis kam (raws li kev rog thiab kub siab); |
|
| raws li cov npe ntawm cov kab mob sib kis thiab cov xwm txheej | kab mob siab tseem ceeb |
- rog thiab / lossis ntshav qab zib; - ua txhaum ntawm lipid metabolism |
| kab mob siab thib ob |
- noj tshuaj nrog cov nyhuv hepatotoxic; - plawv tsis ua hauj lwm; - oncology; - poob ceeb thawj; - kab mob ntev ntawm txoj hnyuv (colitis, pancreatitis); - kev phais loj |
|
| los ntawm qhov xwm txheej ntawm tus kab mob | ntsim |
- lom nrog tshuaj lom (arsenic, fluorine, overdosetshuaj, cawv); - kab mob siab; - sepsis |
| mob |
- ua txhaum ntawm lipid metabolism; - tsis muaj protein ntau, qee cov zaub mov thiab cov vitamins; - cawv; |
|
| Raws li tus kab mob hnyav | steatosis | Steatosis yog theem I ntawm ALD thiab NAFLD, ua rau muaj npe saum toj no |
| steatohepatitis | Steatosis dhau mus rau theem II - steatohepatitis nyob rau hauv cov xwm txheej uas cov txheej txheem inflammatory koom nrog fatty infiltration | |
| fibrosis |
Yog tias kev kho thiab kev tiv thaiv tsis tau coj mus rau theem I thiab II ntawm tus kabmob, ces tus kabmob kis mus rau theem III - fibrosis. Risk yam yog: - laus; - mob ntshav qab zib mellitus; - ua tiav (obesity); - piv ntawm kev ua ntawm transaminases ASaT / ALAT > 1 |
|
| cirrhosis/siab cancer (tsis tshua muaj) | Fibrosis yog ib qho kev hloov pauv tsis tau hauv daim siab cov ntaub so ntswg nrog kev kawm ntev, uas thaum kawg ua rau theem IV - cirrhosis |
yam tsis zoo uas tuaj yeem ua lub zog rau kev loj hlob thiab kev loj hlob ntawm tus kab mob ntxiv yog:
- hypodynamia;
- kev nyuaj siab;
- genetic predisposition;
- kev noj haus (hais tias tshaib plab);
- ib puag ncig phem.
Ntau yam laj thawj thiab ntau yam tuaj yeem ua rau muaj kev loj hlob ntawm cov kab mob xws li kev rogdaim siab. Yuav ua li cas kho ZhBP feem ntau nyob ntawm hom, theem, qhov hnyav ntawm daim siab rog.
Kev kho mob tshwm sim ntawm FLD
Nws yog ib qho tseem ceeb heev uas yuav tau kuaj xyuas ntxov thiab pib kho sai li sai tau. Hmoov tsis, tus kab mob yog insidious - nws yog yuav luag asymptomatic. Tsuas muaj cov cim qhia dav dav uas tuaj yeem pom lawv tus kheej hauv ntau lwm yam mob:
- faus;
- mob nkees (tam sim no txawm tias tom qab pw tsaug zog);
- qaug zog, qaug zog, kev xav tsis muaj zog.
Tej zaum yuav muaj cov tsos mob pom tseeb dua los saib rau:
- hnyav (tsis xis nyob) thiab / lossis mob hauv txoj cai hypochondrium;
- ua txhaum cov quav (hloov hauv qhov sib xws, tsis hnov tsw, xim);
- txo qis qab los noj mov (tsis muaj kev txaus siab los ntawm kev noj mov);
- -jaundice ntawm daim tawv nqaij.
Vim txoj kev ua neej nyob tsis muaj zog, ib puag ncig, cov khoom ua tiav ib nrab uas tib neeg tau siv los noj txhua hnub, ib tus kab mob xws li cov rog rog tau dhau los ua qhov loj ntawm lub xyoo pua 21st. Cov tsos mob, kev kho mob thiab kev tiv thaiv kev rog rog yog cov ntaub ntawv tseem ceeb uas ib tus neeg niaj hnub yuav tsum kawm kom tsis txhob dhau los ua "txhua thib ob" hauv cov ntaub ntawv poob siab txog qhov tshwm sim ntawm tus kab mob no thoob plaws ntiaj teb.
Kev kuaj mob siab
Kev tiv thaiv kab mob rog rog yog yooj yim tiv thaiv dua li kho, yog li yog tias muaj ib lossis ntau cov tsos mob tshwm sim, mus ntsib kws kho mob tshwj xeeb. Feem ntau qhov no yog tus kws kho mob, tus kws kho mob gastroenterologist,kws kho mob siab. Thaum kuaj, koj yuav tsum qhia tus kws kho mob tias qhov kev txhawj xeeb tiag tiag rau koj, dab tsi tshwm sim. Tus kws kho mob yuav tshuaj xyuas daim tawv nqaij, thiab txiav txim siab los ntawm palpation seb puas muaj lub siab loj. Kev kuaj mob ntawm tus kab mob tshwm sim nyob rau hauv ob peb theem. Nws yuav tsim nyog kom dhau cov qauv xeem: UAC, OAM, cal. Cov txheej txheem qhia paub ntau tshaj tau nthuav tawm hauv cov lus hauv qab no.
| ntsuas ntsuas ntshav biochemical | Norma |
| YTag nrho serum protein | 65-85g/l |
| Bilirubin tag nrho | qis dua 3, 3-17, 2 µmol/l |
| YBilirubin direct | 0-3, 41 µmol/L |
| Bilirubin indirect | 3, 41-13, 6 µmol/L |
| YGlucose | 4, 45-6, 37 mmol / L (tus neeg laus) |
| YBile acids | 2, 4-6, 8 mmol/L |
|
0.31-0.9 mmol/L (tus neeg laus); ntau dua 1.2 mmol / l (cov menyuam yaus thiab cov neeg laus muaj qhov sib txawv ntawm kev rog) |
|
| ntshav lipids |
HDL (siab ceev lipids): 1, 51-3, 4 g/l (tus neeg laus) LDL (tsis tshua muaj lipids): 3, 21-5, 5g/L |
| YAminotransferases (transaminases) |
ALAT: 0, 13-0, 87 MKC/L, 28-190 nmol/(s x l), 0, 1-0.67 µmol/(ml x h), 7-54 IU/L; ASAT: 0, 17-0, 77 MKC/L, 28-125 nmol/(s x l), 0, 1-0, 46µmol/(ml x h), 11-43 IU/L |
| Alkaline Phosphatase | 278-830 nmol/(s x l) |
| tsawg dua 5.0-5.2 mmol / l |
Tseem kuj tseem muaj txoj hauv kev los tshuaj xyuas qhov chaw retroperitoneal (spleen, siab, gallbladder, ob lub raum, pancreas): ultrasound, CT, MRI.
Feem ntau, daim siab thiab tus po tsis loj. Lub thickness ntawm sab xis lobe ntawm lub siab yog 112-126 hli, sab laug yog hais txog 70 hli (cov neeg laus). Hauv cov menyuam yaus, qhov loj ntawm daim siab nyob ntawm lub hnub nyoog, yog tias thaum muaj hnub nyoog 1 xyoos, qhov tuab ntawm 60 hli yog qhov qauv rau sab xis lobe ntawm daim siab, sab laug yog 33 hli, tom qab ntawd thaum muaj hnub nyoog 18 xyoo cov duab yog ze rau hnub nyoog. cov cai. Cov contours yog meej thiab txawm, cov qauv yog homogeneous, echogenicity yuav tsum tsis txhob nce los yog txo. Feem ntau, qhov luaj li cas ntawm cov kab mob hauv lub cev yog 6-8 hli, cov hlab ntsha portal txog li 13 hli, thiab txoj kab uas hla ntawm vena cava yog txog 15 hli.
Ntawm txhua txoj hauv kev ua tau, daim siab biopsy yog txoj hauv kev zoo tshaj plaws los kuaj xyuas kom raug.
Kev kho thiab kev kuaj mob rau cov neeg mob FAD
Txawm hais tias kev kho mob ntawm qib I-II fatty siab yog cov txheej txheem ntev thiab ua haujlwm hnyav, qhov kev cia siab rau cov neeg mob zoo li no. Nyob rau hauv theem ntawm fibrosis, txhua yam nyob ntawm nws cov degree thiab nyob rau hauv yuav ua li cas lub cev reacts rau kev kho mob tshuaj, seb puas muaj ib tug zoo sib xws. Cirrhosis kawg yuav tsum tau hloov daim siab. Hom kev ua haujlwm no yog qhov kim tshaj plaws hauv ntiaj teb. Kev kwv yees rau cov neeg zoo li no nyob ntawm cov khoom siv thiabCov yam ntxwv ntawm lub cev (lub sijhawm rov qab kho dua tshiab).
Dab tsi suav nrog hauv kev kho mob rog rog? Lub siab rog xav tau ntau txoj kev ntsuas: los ntawm kev hloov kev noj haus thiab kev ua neej mus rau kev siv tshuaj kho.
Yog tias muaj teeb meem daim siab tau pib, nws raug nquahu kom ua raws li cov cai hauv qab no tag nrho koj lub neej, uas yuav tsum tau ua raws li kev tiv thaiv kev rog rog:
- khoom noj (feem ntau yog rooj naj npawb 5);
- kev ua si (kev tawm dag zog nruab nrab);
- tuav qhov hnyav hauv qhov qub, nrog rau kev rog, nws yog qhov tsim nyog los nrhiav qhov ua rau cov kab mob metabolic, tsim kom muaj cov txheej txheem metabolic;
- ua raws li txoj cai ntawm kev ua haujlwm thiab so;
- noj tshuaj los ntawm kws kho mob los tswj thiab kho cov kab mob siab (hepatoprotectors, lipoic acid, B vitamins).
Yog ALD nyob rau hauv daim ntawv mob hnyav, nws txaus kom tsis txhob haus cawv - nrog kev kho mob, lub siab muaj peev xwm rov qab tau sai. NAFLD yuav tsum tau kho cov kab mob hauv qab los yog tshem tawm cov teeb meem tsis zoo (nyob ntawm seb qhov twg yog qhov ua rau lub hauv paus).
Kev kho mob tsis zoo rau "fatty" siab
Yog koj tsis xav noj tshuaj, yuav ua li cas kho lub siab? Cov tshuaj pej xeem yuav pab tshem tawm tus kab mob. Nws yog tsim nyog nco ntsoov tias nyob rau hauv lwm yam tshuaj muaj contraindications, yog li koj yuav tsum nco ntsoov nrog ib tug kws kho mob.
Muaj ntau ntau yam tshuaj ntsuab zaub mov txawv rau kev kho lub siab rog, ntawm no yog qee qhov zoo tshaj plaws:
- Koj yuav tsum noj 2 feem ntawm cov khoom xyaw hauv qab no: birch buds, nettle nplooj, lungwort tshuaj ntsuab, qab zib clover. 3 qhov chaw ntawm raspberry nplooj thiab licorice paus. 1 feem ntawm dill thiab skullcap cag. Lub resulting sau yuav tsum tau crushed. Tom qab ntawd ncuav 2 tbsp. l. Nyob rau hauv ib lub thermos thiab ncuav 1/2 liter ntawm boiling dej, sawv ntsug kom txog thaum sawv ntxov. Noj 0.5 khob txog 4 zaug hauv ib hnub rau ob peb lub hlis. Tom qab so rau 2 lub lis piam, brew ib qho tshiab thiab rov kho dua.
- 2 tbsp. l. crushed mint nplooj ncuav 150 grams ntawm boiling dej. Cia lub broth kom txog thaum sawv ntxov, ces faib ua 3 qhov sib npaug thiab haus ib hnub; Nyob rau yav tsaus ntuj, ncuav 50 g ntawm qhuav rosehips rau hauv ib lub thermos thiab ncuav 1/2 liter ntawm boiling dej. Cia lub broth brew kom txog thaum sawv ntxov. Haus 200 g ntawm decoction 3 zaug ib hnub twg. Ib yam li ntawd, pob kws stigmas tuaj yeem brewed. Cov zaub mov zoo li no haum rau kev ntxiv dag zog rau daim siab hepatocytes.
Txhawm rau kom kev kho mob zoo, nws raug nquahu kom ntxuav tag nrho lub cev ntawm co toxins thiab co toxins ua ntej nws pib. Hauv cov tshuaj pej xeem, muaj ntau yam zaub mov txawv rau "mos" ntxuav lub siab.
Kev tiv thaiv kab mob rog rog
Yog tias koj yuam koj tus kheej kom ua qee yam kev tiv thaiv, koj tsis tuaj yeem ua tiav qhov txiaj ntsig zoo. Nws yuav tsum tsis txhob "los ntawm kev quab yuam", "qee zaus", tab sis ua ib txoj hauv kev ntawm lub neej. Tsuas yog tom qab ntawd yuav tiv thaiv thiab kho kom zoo siab.
Tsis nco qablub ntsiab lus qab ntxiag tshaj, tab sis tsim nyog: "Fatty siab: kev kho mob, cov tsos mob." Kev noj zaub mov yog qhov yuav tsum tau saib xyuas tshaj plaws hauv kev tiv thaiv FAD.
Nws yog ib qho tsim nyog yuav tsum txo kom tsawg ntawm cov tsiaj rog los ntawm kev ua kom cov zaub rog ntau ntxiv. Tsis txhob zom cov carbohydrates yooj yim xws li qab zib. Noj cov zaub mov uas muaj fiber ntau - lawv pab ua kom sai sai thiab muaj calorie ntau ntau. Koj yuav tsum tsis txhob tso tseg tag nrho cov nqaij, nws yog ib qho tseem ceeb kom tsis txhob noj cov rog tsis zoo. Txhawm rau ua qhov no, koj yuav tsum noj cov khoom noj muaj roj tsawg, cov khoom noj nqaij. Noj yuav tsum yog feem ntau 5-6 zaug hauv ib hnub, zom kom huv. Los ntawm kev ua raws li cov cai yooj yim, koj tuaj yeem zam qhov kev kuaj mob xws li daim siab rog. Yuav ua li cas kho cov kab mob fatty hepatosis, kev tiv thaiv dab tsi los siv? Cov lus nug no yuav tsis tshwm sim yog tias koj coj txoj kev ua neej zoo.
Lub siab yog lub caj pas digestive loj tshaj plaws hauv lub cev. Nws ua haujlwm uas tib neeg lub neej thiab kev noj qab haus huv nyob ntawm. Cov txheej txheem co toxins thiab txhawb nqa lawv tshem tawm, khaws cov khoom muaj txiaj ntsig tsim nyog los ua kom lub zog tseem ceeb - thiab qhov no tsis yog txhua yam uas lub cev txuj ci tseem ceeb no ua los txhawb kev ua haujlwm tseem ceeb.
Lub siab yog qhov tshwj xeeb hauv nws lub peev xwm rov tsim dua tshiab. Kev kho dua qub ntawm qhov ntim dhau los yog ua tau txawm tias 3/4 ntawm daim siab cov ntaub so ntswg puas lawm. Xws li lub siab muaj zog, uas tsis ua rau nws tus kheej paub txog qhov kawg, tseem xav tau peb tus cwj pwm zoo rau nws. Noj qab nyob zoo txoj kev ua neej (kev ua si, khoom noj khoom haus kom zoo, kev ua haujlwm thiab so kom txaus) thiabkev kuaj mob (tsawg kawg ib xyoos ib zaug) yog tus yuam sij rau kev ua neej nyob ntev, ib txoj hauv kev kom tsis txhob muaj ntau yam kab mob thiab lawv qhov tshwm sim tsis zoo.
